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Tuesday, April 30, 2013

Expanding
Medicaid to cover an estimated 500,000 Michigan residents without medical
coverage can provide mental health care for thousands who without treatment
could end up homeless, receiving expensive emergency rooms care or in prison, mental
health experts say.

“It
is sensible public policy to tap federal funds
already set aside to expand preventive and life-saving health care under
Medicaid,” said Mike Vizena, executive director, Michigan Association of
Community Mental Health Boards.

Expansion represents the best single opportunity to improve
access to behavioral health-care services for Michigan’s citizens most in need,
he added.

Paul
Tarr, a legislative liaison for the Department of Community Health, agreed.

“It
is my belief Medicaid reform will definitely help people with mental and
physical disabilities,” said Tarr.

Cuts to general fund support for mental health and
substance use disorder services during the past decade “have resulted in a lack
of access, reduction of services and creation of waiting lists for persons
without Medicaid,” Vizena said.

As a result, he said persons with emerging mental health and
substance use disorders are not seen for care and end up in emergency room and
hospitals “where their cost of care is 20 times greater” than if they had
Medicaid coverage.

“Far too often these citizens wind up in criminal justice
proceedings, or, in some cases, become homeless places where they do not belong
and where they will not receive the care they need,” he said.

Last
month, a House subcommittee removed Gov. Snyder’s proposed Medicaid expansion
from its budget and in mid-April a Senate subcommittee did the same. The bills
are SB198 and HB4213. Lawmakers in the state House and Senate are facing a June
1 self-imposed deadline to finish the state budget.

Efforts
are under way by Michigan hospitals, mental health care providers, physicians,
the Detroit Regional Chamber, the Small Business Association of Michigan and
the Michigan Business and Professional Association to lobby Republicans who
oppose Medicaid expansion to change their minds.

Studies
have shown Michigan could save $1 billion in healthcare health care
expenditures if it expands Medicaid to people with incomes up to 138 percent of
the federal poverty level.

Michigan
could receive $2 billion in federal funds during the next decade to finance
those who become eligible for Medicaid such as the mentally ill. Snyder has
said expanding Medicaid also will help some businesses with 50 provide coverage
for workers under the Patient Protection and Affordable Care Act.

“The Michigan House of Representatives has
supported this but the Senate, at this time, is worried about the federal
government going to the extreme as far as its authority to cover costs of
Medicaid reform,” said Tarr.

Cuts
to general fund support for mental health and substance use disorder services
during the past decade have resulted in a lack of access, reduction of services
and creation of waiting lists for a person without private insurance or
Medicaid, he noted.

“In time, I think Michigan will reform
Medicaid,” Tarr said. “I support Medicaid reform and the Senate needs time to
let it seep like a good cup of tea.”

Last
month, a House subcommittee removed Snyder’s proposed Medicaid expansion from
its budget and in mid-April a Senate subcommittee did the same. The bills are
SB198 and HB4213.

Vizena
also said expanding Medicaid would:

nHelp
local community hospitals. “If the Michigan Legislature does not support
Medicaid expansion, lawmakers jeopardize the financial stability of local
hospitals across the state.”

nRequire
the federal government to cover the full cost of expansion through 2016, before
gradually reducing funding to 90 percent by 2020.

nProtect
more than 300,000 of Michigan’s most vulnerable residents in the next year
alone; decrease the rate of emergency room visits that drive up health care
costs for everyone and save the state millions a year in state spending.

nPossibly
create 18,000 new health-care jobs and generate $2.1 billion in new economic
activity in Michigan.

“Expansion represents the best single
opportunity to improve access to behavioral health-care services for Michigan’s
citizens most in need,” Vizena said.

Jerry
Wolffe is the Disability Rights Advocate/Writer in Residence at MORC Inc., a
nonprofit that provides services to 5,100 people with disabilities in Oakland, Macomb,
and Wayne counties.